BALTIMORE, Md. (Ivanhoe Newswire)— Lower back pain, fatigue, and nausea. Symptoms that could be caused by any number of illnesses, but they’re also the hallmark signs of a serious condition called nutcracker syndrome where the veins in the lower abdomen are squeezed and restrict blood flow.
Thirty-five-year-old Kristine Sohn and her husband Eric met in eighth grade science class. The middle-school sweethearts are now partners in life and as church volunteers rehabbing homes after natural disasters.
“We’ll go in and work on those trees with the chainsaws,” Kristine Sohn told Ivanhoe.
But for more than ten years, Kristine often felt fatigue or pain in her side and back. Then two years ago, new symptoms that were even more troubling.
Kristine Sohn shared, “For about six months I was experiencing blood in the urine.”
“By the time blood in the urine became an issue we had already dealt with so many other things that it was one of those, okay, well now we have a clue that we could start looking towards,” Eric Sohn, Kristine’s husband, noted.
Kristine was referred to vascular surgeon, Kurtis Kim, MD, director of the Institute of Comprehensive Venous Diseases and Vascular Compression Syndromes at Mercy. Dr. Kim diagnosed Kristine with nutcracker syndrome, a condition where abdominal arteries squeeze the vein leading to the kidneys.
Dr. Kim said, “So, you could imagine the nutcracker being cracked like this, where the renal vein gets really gets compressed here.”
To relieve the pressure Dr. Kim threaded a small tube through a catheter into Kristine’s abdomen, to perform what’s called endovascular stenting.
“The stent, or graft that goes outside of the vein, so that the compression, whatever is compressing, it is lifted up,” Dr. Kim shared.
Kristine started feeling much better immediately.
“It was very, very painless, very minimal,” declared Kristine.
Eric Sohn exclaimed, “It was pretty incredible.”
In fact, just eight weeks later, Kristine and Eric were once again teamed up on rooftops. Partners in sickness and in health.
In addition to nutcracker syndrome, Doctor Kim also diagnosed Kristine with an additional vein compression condition called May-Thurner syndrome. She received additional treatment for that condition.
Contributors to this news report include: Cyndy McGrath, Producer; Kirk Manson, Videographer; Roque Correa, Editor.
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MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY
TOPIC: NUTCRACKER SYNDROME SURGERY TAKES THE SQUEEZE AWAY
REPORT: MB #4968
BACKGROUND: There are two main types of nutcracker syndrome: anterior and posterior. The most common type is anterior nutcracker syndrome, where the left renal vein is compressed between the aorta and another abdominal artery. In posterior nutcracker syndrome, the left renal vein is compressed between the aorta and the spine. Nutcracker syndrome got its name because the compression of the renal vein is like a nutcracker cracking a nut. Symptoms are most often caused when the left renal vein coming from the left kidney becomes compressed and blood can’t flow normally through it. Instead, blood flows backwards into other veins and causes them to swell.
(Source: https://www.healthline.com/health/nutcracker-syndrome)
SYMPTOMS AND DIAGNOSIS: Some common symptoms of nutcracker syndrome include blood in the urine; pelvic pain; pain in the side or abdomen; protein in the urine, which can be determined by a doctor; pain during intercourse; enlarged veins in testicles; and lightheadedness while standing, but not while sitting. A doctor will perform a physical exam and take a medical history and ask about symptoms to help narrow down a diagnosis. If nutcracker syndrome is suspected, the doctor will take urine samples to look for blood, protein, and bacteria. Next, the doctor may recommend a Doppler ultrasound of the kidney area to see if there’s any abnormal blood flow through the veins and arteries. A CT scan or MRI may be recommended to look more closely at the kidneys, blood vessels, and other organs to see exactly where and why the vein is compressed.
(Source: https://www.healthline.com/health/nutcracker-syndrome#symptoms)
A MINIMALLY INVASIVE ALTERNATIVE: The most widely used treatment options for nutcracker syndrome include open vascular approaches, laparoscopic techniques, and the placement of endovascular stents. Laparoscopic techniques, compared with open surgeries, are less invasive and associated with reduced post-operative morbidity. Vascular stent treatment, including the placement of both internal and external vascular stents, has become a desirable option that is minimally invasive with good results. Improvements have been seen in left renal vein diameter after placement of stents, as well as in the peak velocity ratio and renocaval pressure gradient in many patients. However, the stenting treatment is not without risks. Complications can include incorrect stent placement and stent migration requiring surgical intervention.
FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:
DAN COLLINS
410-332-9714
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